Digestive Disorder Testing
Posted 08 March 2017 - 04:11 PM
I recently had the opportunity to oversee a clinical study, involving diagnosing digestive disorders. The study reviewed several GI related diagnostic tests that are currently available. The tests included, the endoscopy test, nasogastric test, stool and urine test, breath test and the pH capsule test.
The two most invasive tests were the endoscopy test and nasogastric test.
The endoscopic test, is an in hospital procedure, that requires sedation. The patient must fast, before taking the test, and have someone accompany them to and from the hospital. After being sedated the endoscopy tube is pushed down the throat into the stomach. While being pushed down the throat, the doctor can visually record the movement through the alimentary canal. The endoscope has the ability to remove polyps and sample fluids. When fluids samples are taken they are immediately sent to a lab to be analyzed. The endoscopic procedure can tell the doctor if a person has acid in their stomach, if they have ulcers, and they can observe duodenal reflux in some instances. The upper and low GI test are two of the most common tests used by gastroenterologist. The test limitation are: it can only enter a small portion of the small bowel, It cannot diagnose gastritis, hypochlorhydria, delayed stomach emptying, or dumping syndrome.The endoscopic test is a very expensive in hospital test.
The nasogastric tube test, requires pushing a catheter up through the nose, then down the throat and into the stomach. Samples of the gastric fluids and be removed from the stomach and sent to a laboratory for testing, to determine acid strength. The test nasogastric test is primarily done in a hospital. The nasogastric tube can also be used for feeding also. The nasogastric tube is primarily used for testing the pH of gastric fluids. The test has a tendency to cause fluids from the duodenum to reflux back into the stomach when the gag reflex occurs. It is one of the most invasive tests available and can cause serious problems. It is also a very expensive test.
The stool and urine tests requires that the patient provide the doctor with fresh stool and urine samples. The samples are take to a lab, or in some cases, testing is done in a doctors office. The pH of the stool and urine, may have some correlation to what is happening in the digestive process, but does not provide a clear picture of how the digestive system is operating. The stool test can be used to test for bacteria and pathogens that are in the digestive process. Depending on the type of lab test requested, the test is reasonable inexpensive.
The urea breath teste is primarily used to diagnose bacteria, specifically H. pylori bacterial. The H. pylori bacteria is believed to be the primary cause of gastritis. The bacteria can cause ulcers, inflammation.The urea breath test is based on the ability of H. pylori to break down urea, a chemical made up of nitrogen and carbon, into carbon dioxide, which then is absorbed from the stomach and eliminated in the breath. (Urea normally is produced by the body from excess or "waste" nitrogen-containing chemicals and then eliminated in the urine). For the test, patients swallow a capsule containing urea made from an isotope of carbon. (Isotopes of carbon occur in minuscule amounts in nature, and can be measured with special testing machines.) If H. pylori is present in the stomach, the urea is broken up and turned into carbon dioxide. The carbon dioxide is absorbed across the lining of the stomach and into the blood. It then travels in the blood to the lungs, where it is excreted in the breath. Samples of exhaled breath are collected, and the isotopic carbon in the exhaled carbon dioxide is measured. The urea breathe test is not use for diagnosing digestive disorders and is limited to detecting bacterial.
The pH capsule test, or Heidelberg test, is an in-office procedure that does not require sedation of the use of a catheter for placement. The test is done in a doctors office. The patient must fast overnight. A small micro-electronic capsule is swallowed with a sip of water. The pH information in the mouth, esophagus, stomach, small intestines and large intestine can be monitored. The pH capsule transmits the pH information in the gut to a receiver worn the patient. The receiver process the information and sends it to a computer there the information is displayed. The pH diagnostic test can quickly and easily tell the doctor what condition the patient has. It will tell the doctor if the patient has low stomach acid, high stomach acid, heavy stomach mucus (from infection or ulceration), pyloric insufficiency (duodenal reflux), acute or sub-acute gastritis, GERD. The doctor can also use the pH capsule to test for delayed stomach emptying, or dumping syndrome. Of all of the test available the Heidelberg test, or pH capsule test is by far the most accurate, and patient friendly. It is also the least expensive test.
Conclusion: The pH capsule test is the best choice for diagnosing digestive disorders.